Paediatric trauma Flashcards
Which gender are fractures more common in
boys
What is the correlation with age and fractures
The older you are, the more likely you are to have had a fracture
What is the correlation between previous fractures and obtaining new fractures
having a previous fracture, increases the risk of obtaining another fracture
What season are paediatric fractures more common in
Summer
What is the most common location for a paediatric fracture to be at
The forearm
Why do children’s fractures heal quickly
They have a good blood supply and a metabolically active periosteum
What are the types of fracture in children
Complete fracture
Greenstick fracture
Buckle fractures
Plastic deformity
What is the Conservative treatment for childrens fractures
casts
braces
splints
traction
What is the operative treatment of paediatric fracture
External fixation - pins are placed into the bone and there is an external frame
Internal fixation - Plate is applied to a broken bone and the fracture reduces
or Inter-medullary nails - placing elastic nails into the bone in children
What causes remodelling of a childrens fracture
Appositional periosteal growth/resorption - children have a thick metabolically active periosteum which smoothens out any abnormalities on the bone by resorption
Where is remodelling most active in bone
metaphysis
What is the correlation between age and remodelling of a fracture
The younger a child is, the greater potential to remodel a fracture
Why are all open fractures debrided
Because they are at risk to infection - removing all damaged or foreign material from the wound
What cast is required for a straight limb
Bent cast
What is the weakest point of the bone
The epiphyseal growth plate- weaker than ligaments
What does the salter harris classification do
Helps predict injuries that may affect growth
List the salter harris classification
SH1 – fracture is along the growth plate
SH2 – fracture begins along the growth plate but then angles off into the metaphysis – most common type
SH1 and 2 have good healing prospects
SH3 – fracture at a right angle to the growth plate – the growth plate tends to displace but the fracture doe s not go into the metaphysis
SH4 – Combination of SH2 and SH3 – goes in an oblique fashion across the growth plate
SH3 +4 – high risk of disturbance when healing
SH-5 – compression of the growth plate – longitudinal compression
What is the most common salter harris fracture
Type 2 - Begins along the growth plate but then agles off into the metaphysis
What are the stages of epiphyseal growth plate fusing
The centre fuses - then the medial side - then the lateral side
What causes non accidental injury
Neglect
Child abuse
What are the warnings of non accidental injury
inconsistent injury
Delay in presentation
Mechanism that doesn’t match the pattern of fracture
bruising
burns
multiple fractures with multiple stages of healing
What is the treatment of osteomyelitis
Prolonged high does antibiotics -
2 weeks IV, 4 weeks oral
What is the most common causing pathogen of osteomyelitis
Staphylococcus
